HSB 100 (LSB 2394YC (3) 91)

HOUSE FILE _____ 

BY  (PROPOSED COMMITTEE ON COMMERCE BILL BY CHAIRPERSON LUNDGREN)

A BILL FOR

An Act relating to cost-sharing requirements for supplemental and diagnostic breast examinations.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 514C.4A, subsection 1, Code 2025, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  0c.  “Cost-sharing” means any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket cost obligation imposed by a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses on a covered person.
    Sec. 2.  Section 514C.4A, subsection 2, Code 2025, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  c.  Cost-sharing requirements imposed for coverage required under this section shall not be less favorable than cost-sharing requirements imposed by a health carrier for screening mammograms.
    Sec. 3.  APPLICABILITY.  This Act applies to third-party payment provider contracts, policies, or plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2026.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to cost-sharing requirements for supplemental and diagnostic breast examinations.
   Under the bill, a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses shall not impose cost-sharing requirements for required coverage of supplemental and diagnostic breast examinations that is less favorable than cost-sharing requirements imposed for screening mammograms.
   “Cost-sharing” is defined in the bill. The bill applies to third-party payment provider contracts, policies, or plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2026.